Late Retrograde Aortic Dissection after Hybrid Thoracic Endovascular Aortic Repair (TEVAR): A Case Report
Abstract
Open total arch replacement is allied to high rates of mortality and morbidity; surgeons, therefore, tend to choose hybrid aortic arch repair as a less invasive operative procedure for the treatment of aortic arch aneurysms, especially in high-risk patients. However, studies on the early and late outcomes of patients undergoing hybrid aortic arch repair have revealed high rates of reintervention and reoperation compared with open total arch replacement. Here, we describe a male patient with late retrograde aortic dissection after hybrid thoracic endovascular aortic repair for aortic arch aneurysms. The patient returned 3 years after the procedure with signs of dyspnea on exertion and chest pain. Transthoracic echocardiography and computed tomography showed dissection of the ascending aorta, for which he underwent a redo Bentall procedure. The patient was weaned from cardiopulmonary bypass without any problem and discharged after 7 days.
1. Gandet T, Canaud L, Ozdemir BA, Ziza V, Demaria R, Albat B, Alric P. Factors favoring retrograde aortic dissection after endovascular aortic arch repair. J Thorac Cardiovasc Surg 2015;150:136-142.
2. Tokuda Y, Oshima H, Narita Y, Abe T, Araki Y, Mutsuga M, Fujimoto K, Terazawa S, Yagami K, Ito H, Yamamoto K, Komori K, Usui A. Hybrid versus open repair of aortic arch aneurysms: comparison of postoperative and mid-term outcomes with a propensity score-matching analysis. Eur J Cardiothorac Surg 2016;49:149-156.
3. Elhelali A, Hynes N, Devane D, Sultan S, Kavanagh EP, Morris L, Veerasingam D, Jordan F. Hybrid repair versus conventional open repair for thoracic aortic arch aneurysms. Cochrane Database Syst Rev 2018;2018:CD012923.
4. Ghanta RK, Mery CM, Kron IL. Aortic dissection. In: Cohn LH, Adams DH, eds. Cardiac Surgery in Adult. 5th ed. New York: Mc Graw Hill Education; 2018. p. 1003-1037.
5. Jaafar R, Mohamad I. Hoarseness as the sole symptom of an impending thoracic aneurysm rupture? Malays Fam Physician 2014;9:25-27.
6. Collins JS, Evangelista A, Nienaber CA, Bossone E, Fang J, Cooper JV, Smith DE, O'Gara PT, Myrmel T, Gilon D, Isselbacher EM, Penn M, Pape LA, Eagle KA, Mehta RH; International Registry of Acute Aortic Dissection (IRAD). Differences in clinical presentation, management, and outcomes of acute type a aortic dissection in patients with and without previous cardiac surgery. Circulation 2004;110(11 Suppl 1):II237-242.
7. Oladokun D, Patterson BO, Sobocinski J, Karthikesalingam A, Loftus I, Thompson MM, Holt PJ. Systematic review of the growth rates and influencing factors in thoracic aortic aneurysms. Eur J Vasc Endovasc Surg 2016;51:674-681.
8. Booher AM, Eagle KA. Diagnosis and management issues in thoracic aortic aneurysm. Am Heart J 2011;162:38-46.e1.
9. Bickerstaff LK, Pairolero PC, Hollier LH, Melton LJ, Van Peenen HJ, Cherry KJ, Joyce JW, Lie JT. Thoracic aortic aneurysms: a population-based study. Surgery 1982;92:1103-1108.
10. Geisbüsch P, Kotelis D, Müller-Eschner M, Hyhlik-Dürr A, Böckler D. Complications after aortic arch hybrid repair. J Vasc Surg 2011;53:935-941.
11. De Rango P, Cao P, Ferrer C, Simonte G, Coscarella C, Cieri E, Pogany G, Verzini F. Aortic arch debranching and thoracic endovascular repair. J Vasc Surg 2014;59:107-114.
12. Al Jabbari O, Abu Saleh WK, Irshad A, Christensen T, Bruckner B, Bismuth J, Loebe M. Case report: delayed type A aortic dissection following complete debranching of the aortic arch and stent graft placement. Methodist Debakey Cardiovasc J 2016;12:45-47.
13. Mosquera VX, Marini M, Fraga-Manteiga D, Gulias D, Cuenca JJ. Repair of late retrograde type A aortic dissection after TEVAR: causes and management. J Card Surg 2016;31:164-167.
14. Yammine H, Briggs CS, Stanley GA, Ballast JK, Anderson WE, Nussbaum T, Madjarov J, Frederick JR, Arko FR, 3rd. Retrograde type A dissection after thoracic endovascular aortic repair for type B aortic dissection. J Vasc Surg 2019;69:24-33.
15. Higashigawa T, Kato N, Chino S, Hashimoto T, Shimpo H, Tokui T, Mizumoto T, Sato T, Okabe M, Sakuma H. Type A aortic dissection after thoracic endovascular aortic repair. Ann Thorac Surg 2016;102:1536-1542.
16. Joo HC, Youn YN, Kwon JH, Won JY, Lee DY, Ko YG, Choi D, Yoo KJ. Late complications after hybrid aortic arch repair. J Vasc Surg 2019;70:1023-1030.e1.
17. Xydas S, Mihos CG, Williams RF, LaPietra A, Mawad M, Wittels SH, Santana O. Hybrid repair of aortic arch aneurysms: a comprehensive review. J Thorac Dis 2017;9:S629-S634.
18. Bachet J. Open repair techniques in the aortic arch are still superior. Ann Cardiothorac Surg 2018;7:328-344.
2. Tokuda Y, Oshima H, Narita Y, Abe T, Araki Y, Mutsuga M, Fujimoto K, Terazawa S, Yagami K, Ito H, Yamamoto K, Komori K, Usui A. Hybrid versus open repair of aortic arch aneurysms: comparison of postoperative and mid-term outcomes with a propensity score-matching analysis. Eur J Cardiothorac Surg 2016;49:149-156.
3. Elhelali A, Hynes N, Devane D, Sultan S, Kavanagh EP, Morris L, Veerasingam D, Jordan F. Hybrid repair versus conventional open repair for thoracic aortic arch aneurysms. Cochrane Database Syst Rev 2018;2018:CD012923.
4. Ghanta RK, Mery CM, Kron IL. Aortic dissection. In: Cohn LH, Adams DH, eds. Cardiac Surgery in Adult. 5th ed. New York: Mc Graw Hill Education; 2018. p. 1003-1037.
5. Jaafar R, Mohamad I. Hoarseness as the sole symptom of an impending thoracic aneurysm rupture? Malays Fam Physician 2014;9:25-27.
6. Collins JS, Evangelista A, Nienaber CA, Bossone E, Fang J, Cooper JV, Smith DE, O'Gara PT, Myrmel T, Gilon D, Isselbacher EM, Penn M, Pape LA, Eagle KA, Mehta RH; International Registry of Acute Aortic Dissection (IRAD). Differences in clinical presentation, management, and outcomes of acute type a aortic dissection in patients with and without previous cardiac surgery. Circulation 2004;110(11 Suppl 1):II237-242.
7. Oladokun D, Patterson BO, Sobocinski J, Karthikesalingam A, Loftus I, Thompson MM, Holt PJ. Systematic review of the growth rates and influencing factors in thoracic aortic aneurysms. Eur J Vasc Endovasc Surg 2016;51:674-681.
8. Booher AM, Eagle KA. Diagnosis and management issues in thoracic aortic aneurysm. Am Heart J 2011;162:38-46.e1.
9. Bickerstaff LK, Pairolero PC, Hollier LH, Melton LJ, Van Peenen HJ, Cherry KJ, Joyce JW, Lie JT. Thoracic aortic aneurysms: a population-based study. Surgery 1982;92:1103-1108.
10. Geisbüsch P, Kotelis D, Müller-Eschner M, Hyhlik-Dürr A, Böckler D. Complications after aortic arch hybrid repair. J Vasc Surg 2011;53:935-941.
11. De Rango P, Cao P, Ferrer C, Simonte G, Coscarella C, Cieri E, Pogany G, Verzini F. Aortic arch debranching and thoracic endovascular repair. J Vasc Surg 2014;59:107-114.
12. Al Jabbari O, Abu Saleh WK, Irshad A, Christensen T, Bruckner B, Bismuth J, Loebe M. Case report: delayed type A aortic dissection following complete debranching of the aortic arch and stent graft placement. Methodist Debakey Cardiovasc J 2016;12:45-47.
13. Mosquera VX, Marini M, Fraga-Manteiga D, Gulias D, Cuenca JJ. Repair of late retrograde type A aortic dissection after TEVAR: causes and management. J Card Surg 2016;31:164-167.
14. Yammine H, Briggs CS, Stanley GA, Ballast JK, Anderson WE, Nussbaum T, Madjarov J, Frederick JR, Arko FR, 3rd. Retrograde type A dissection after thoracic endovascular aortic repair for type B aortic dissection. J Vasc Surg 2019;69:24-33.
15. Higashigawa T, Kato N, Chino S, Hashimoto T, Shimpo H, Tokui T, Mizumoto T, Sato T, Okabe M, Sakuma H. Type A aortic dissection after thoracic endovascular aortic repair. Ann Thorac Surg 2016;102:1536-1542.
16. Joo HC, Youn YN, Kwon JH, Won JY, Lee DY, Ko YG, Choi D, Yoo KJ. Late complications after hybrid aortic arch repair. J Vasc Surg 2019;70:1023-1030.e1.
17. Xydas S, Mihos CG, Williams RF, LaPietra A, Mawad M, Wittels SH, Santana O. Hybrid repair of aortic arch aneurysms: a comprehensive review. J Thorac Dis 2017;9:S629-S634.
18. Bachet J. Open repair techniques in the aortic arch are still superior. Ann Cardiothorac Surg 2018;7:328-344.
| Files | ||
| Issue | Vol 16 No 1 (2021): J Teh Univ Heart Ctr | |
| Section | Case Report(s) | |
| DOI | https://doi.org/10.18502/jthc.v16i1.6601 | |
| Keywords | ||
| Aorta; thoracic Aneurysm Dissection | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Boroumand S, Ahmadi-Tafti SH, Davoodi S, Forouzannia SK. Late Retrograde Aortic Dissection after Hybrid Thoracic Endovascular Aortic Repair (TEVAR): A Case Report. J Tehran Heart Cent. 2021;16(1):38-41.
